Advertisement

What are adolescents’ experiences of body dissatisfaction and dieting, and what do they recommend for prevention? A qualitative study

  • Helen SharpeEmail author
  • Katharine Damazer
  • Janet Treasure
  • Ulrike Schmidt
Original Article

Abstract

Body dissatisfaction and dieting are risk factors for eating disorders. Understanding young people’s views about factors underlying body dissatisfaction and dieting may be helpful for those designing preventative interventions. This study explored adolescents’ views on causes of body dissatisfaction and dieting and recommendations for prevention. Four 1-h focus groups were conducted with 22 female adolescents (aged 13–15 years). Transcripts were explored using thematic analysis. Body dissatisfaction and dieting was explained by four themes: peer acceptance; social comparison online; pressure from family; and pressure from the media and fashion industries. There were seven areas of recommendation for prevention: building sources of support; learning to be critical of the media; monitoring the school gym; working with parents; educating about signs and symptoms of eating disorders; working with people who have suffered from eating disorders; and providing help from professionals. Implications of these findings for the development of prevention programmes are discussed.

Keywords

Body dissatisfaction Dieting Adolescent Qualitative Prevention 

Notes

Acknowledgments

This report/article presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0606-1043). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. This work was supported by a grant from the NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King’s College London.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Stice E, Whitenton K (2002) Risk factors for body dissatisfaction in adolescent girls: a longitudinal investigation. Dev Psychol 38:669–678PubMedCrossRefGoogle Scholar
  2. 2.
    Neumark-Sztainer D, Wall M, Larson NI et al (2011) Dieting and disordered eating behaviors from adolescence to young adulthood: findings from a 10-year longitudinal study. J Am Diet Assoc 111:1004–1011PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Patton GC, Johnson-Sabine E, Wood K et al (1990) Abnormal eating attitudes in London schoolgirls—a prospective epidemiological study: outcome at twelve month follow-up. Psychol Med 20:383–394PubMedCrossRefGoogle Scholar
  4. 4.
    Stice E, Marti CN, Durant S (2011) Risk factors for onset of eating disorders: evidence of multiple risk pathways from an 8-year prospective study. Behav Res Ther 49:622–627PubMedCrossRefGoogle Scholar
  5. 5.
    Patton GC, Selzer R, Coffey C et al (1999) Onset of adolescent eating disorders: population based cohort study over 3 years. Br Med J 318:765–768CrossRefGoogle Scholar
  6. 6.
    Ghaderi A, Scott B (2001) Prevalence, incidence and prospective risk factors for eating disorders. Acta Psychiatr Scand 104:122–130PubMedCrossRefGoogle Scholar
  7. 7.
    Killen JD, Taylor CB, Hayward C et al (1996) Weight concerns influence the development of eating disorders: a 4-year prospective study. J Consult Clin Psychol 64:936–940PubMedCrossRefGoogle Scholar
  8. 8.
    Stice E, Marti CN, Rohde P et al (2011) Testing mediators hypothesized to account for the effects of a dissonance-based eating disorder prevention program over longer term follow-up. J Consult Clin Psychol 79:398–405PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Clark L, Tiggemann M (2006) Appearance culture in nine- to 12-year-old girls: media and peer influences on body dissatisfaction. Soc Dev 15:628–643CrossRefGoogle Scholar
  10. 10.
    Field A, Camargo CA, Taylor C et al (2001) Peer, parent, and media influences on the development of weight concerns and frequent dieting among preadolescent and adolescent girls and boys. Pediatrics 107:54–60PubMedCrossRefGoogle Scholar
  11. 11.
    McCabe MP, Ricciardelli LA (2003) Sociocultural influences on body image and body changes among adolescent boys and girls. J Soc Psychol 143:5–26PubMedCrossRefGoogle Scholar
  12. 12.
    Jones DC, Crawford JK (2006) The peer appearance culture during adolescence: gender and body mass variations. J Youth Adolesc 35:257–269CrossRefGoogle Scholar
  13. 13.
    Jones DC (2004) Body image among adolescent girls and boys: a longitudinal study. Dev Psychol 40:823–835CrossRefGoogle Scholar
  14. 14.
    Myers TA, Crowther JH (2009) Social comparison as a predictor of body dissatisfaction: a meta-analytic review. J Abnorm Psychol 118:683–698PubMedCrossRefGoogle Scholar
  15. 15.
    Stice E (2001) A prospective test of the dual-pathway model of bulimic pathology: mediating effects of dieting and negative affect. J Abnorm Psychol 110:124–135PubMedCrossRefGoogle Scholar
  16. 16.
    Menzel JE, Schaefer LM, Burke NL et al (2010) Appearance-related teasing, body dissatisfaction, and disordered eating: a meta-analysis. Body Image 7:261–270PubMedCrossRefGoogle Scholar
  17. 17.
    Meyer C, Waller G (2001) Social convergence of disturbed eating attitudes in young adult women. J Nerv Ment Dis 189:114–119PubMedCrossRefGoogle Scholar
  18. 18.
    Paxton SJ, Schutz HK, Wertheim EH et al (1999) Friendship clique and peer influences on body image concerns, dietary restraint, extreme weight-loss behaviors, and binge eating in adolescent girls. J Abnorm Psychol 108:255–266PubMedCrossRefGoogle Scholar
  19. 19.
    Nichter M (2001) Fat talk: what girls and their parents say about dieting. Harvard University Press, CambridgeGoogle Scholar
  20. 20.
    Nichter M, Vuckovic N. Fat talk: body image among adolescent girls. In: Sault N, editor. Many mirrors: body image and social relations. New Jersey: Rutgers University Press; 1994. pp. 109–131Google Scholar
  21. 21.
    Wertheim EH, Paxton SJ, Schutz HK et al (1997) Why do adolescent girls watch their weight? An interview study examining sociocultural pressures to be thin. J Psychosom Res 42:345–355PubMedCrossRefGoogle Scholar
  22. 22.
    Tiggemann M, Gardiner M, Slater A (2000) “I would rather be size 10 than have straight A’s”: a focus group study of adolescent girls’ wish to be thinner. J Adolesc 23:645–659PubMedCrossRefGoogle Scholar
  23. 23.
    Haines J, Neumark-Sztainer D, Thiel L (2007) Addressing weight-related issues in an elementary school: what do students, parents, and school staff recommend? Eat Disord 15:5–21PubMedCrossRefGoogle Scholar
  24. 24.
    Stice E, Marti CN, Shaw H et al (2009) An 8-year longitudinal study of the natural history of threshold, subthreshold, and partial eating disorders from a community sample of adolescents. J Abnorm Psychol 118:587–597PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Stiles WB (1999) Evaluating qualitative research. Evid Based Ment Health 2:99–101CrossRefGoogle Scholar
  26. 26.
    Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3:77–101CrossRefGoogle Scholar
  27. 27.
    McCabe MP, Ricciardelli LA (2005) A prospective study of pressures from parents, peers, and the media on extreme weight change behaviors among adolescent boys and girls. Behav Res Ther 43:653–668PubMedCrossRefGoogle Scholar
  28. 28.
    Baker KJM. Tragic trend: teens ask YouTube commenters if they’re ugly. Jezebel 2012 [cited 2012 March]. http://jezebel.com/5886241/teens-are-now-asking-youtube-commenters-if-theyre-ugly
  29. 29.
    Haferkamp N, Krämer NC (2011) Social comparison 2.0: examining the effects of online profiles on social-networking sites. Cyberpsychol Behav Soc Netw 14:309–314PubMedCrossRefGoogle Scholar
  30. 30.
    Sebastian C, Viding E, Williams KD et al (2011) Social brain development and the affective consequences of ostracism in adolescence. Brain Cogn 72:134–145CrossRefGoogle Scholar
  31. 31.
    Piran N (1999) Eating disorders: a trial of prevention in a high risk school setting. J Prim Prev 20:75–90CrossRefGoogle Scholar
  32. 32.
    McVey G, Tweed S, Blackmore E (2007) Healthy schools-healthy kids: a controlled evaluation of a comprehensive universal eating disorder prevention program. Body Image 4:115–136PubMedCrossRefGoogle Scholar
  33. 33.
    Knightsmith J. “We just don’t know how best to help”: staff experiences of eating disorders in UK schools in academy for eating disorders, international conference on eating disorders. 2010: SalzburgGoogle Scholar
  34. 34.
    Neumark-Sztainer D, Story M, Coller T (1999) Perceptions of secondary school staff toward the implementation of school-based activities to prevent weight-related disorders: a needs assessment. Am J Health Promot 13:153–156PubMedCrossRefGoogle Scholar
  35. 35.
    Piran N (2004) Prevention series. Eat Disord 12:1–9PubMedCrossRefGoogle Scholar
  36. 36.
    Richardson SM, Paxton SJ (2010) An evaluation of a body image intervention based on risk factors for body dissatisfaction: a controlled study with adolescent girls. Int J Eat Disord 43:112–122PubMedGoogle Scholar
  37. 37.
    Wilksch SM, Wade TD (2009) Reduction of shape and weight concern in young adolescents: a 30-month controlled evaluation of a media literacy program. J Am Acad Child Adolesc Psychiatry 48:652–661PubMedCrossRefGoogle Scholar
  38. 38.
    Haines J, Neumark-Sztainer D, Perry CL et al (2006) V.I.K. (Very Important Kids): a school-based program designed to reduce teasing and unhealthy weight-control behaviors. Health Educ Res 21:884–895PubMedCrossRefGoogle Scholar
  39. 39.
    Warschburger P, Helfert S, Krentz EM (2011) POPS: a school-based prevention programme for eating disorders. J Public Health 19:367–376Google Scholar
  40. 40.
    McVey G, Lieberman M, Voorberg N et al (2003) School-based peer support groups: a new approach to the prevention of disordered eating. Eat Disord 11:169–185PubMedCrossRefGoogle Scholar
  41. 41.
    Moreno AB, Thelen MH (1993) A preliminary prevention program for eating disorders in a junior high school population. J Youth Adolesc 22:109–124CrossRefGoogle Scholar
  42. 42.
    Wilksch SM, Tiggemann M, Wade TD (2006) Impact of interactive school-based media literacy lessons for reducing internalization of media ideals in young adolescent girls and boys. Int J Eat Disord 39:385–393PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  • Helen Sharpe
    • 1
    Email author
  • Katharine Damazer
    • 1
  • Janet Treasure
    • 1
  • Ulrike Schmidt
    • 1
  1. 1.King’s College London, Section of Eating DisordersInstitute of PsychiatryLondonUK

Personalised recommendations